Back in the cockpit after a temporary ground hold

When Brian Malek was a young child, he attended a number of air shows with his father and grandfather.

“There was something about flying that intrigued me,” he recalls.

He took his first flying lessons at 18, and thought for a while he wanted to go into the Air Force. Instead, he went the commercial route. He likes flying out west, particularly over California. Vancouver takes the prize for his favorite destination.

But on June 18, 2018, Malek took a different type of flight – one that sent him head-first over the handlebars of his mountain bike at Steamboat Bike Park at Steamboat Resort.

“When I hit my head and my right leg and arm started to go numb, my initial thought was, ‘I might be paralyzed,’” he said.

A guys’ trip

Malek was visiting Steamboat Springs with his brother-in-law, Doug Fashenpour, and his nephew, Zach. They had a condo overlooking the mountain and had taken advantage of their fair share of golfing, fishing and mountain biking.

“We came to Steamboat Springs last summer and had a great time,” said Malek. “But the gondola was down for maintenance and repairs then, so we were glad to be able to get up the mountain this year on our bikes.”

The group had rented bikes and safety gear from a shop at the base of the mountain, including helmets with full face protection.

They had been riding for half the day and for the last run, decided to tackle a black trail for advanced riders called Upper Rawhide. It turned out to be a double black, typically reserved for expert riders.

“We started down the trail and it seemed like it was going to be similar to a regular black,” said Malek. “Instead, the terrain went from zero to one hundred in a split second. It was rocky and there were big roots everywhere.”

Get me out of here

The next thing he knew, Malek was airborne. He flew headfirst over his handlebars and hit his head as he landed.

“As soon as I hit, I knew it was bad,” he said. “I yelled at Doug, ‘It’s bad. Get me out of here.’”

Malek caught his breath while Fashenpour went up the trail for the bike patrollers who were working at the top. The patrollers got to Malek and performed an initial assessment. A truck was able to access them via another trail. A neck brace was placed on Malek and he was on his way down the mountain to the emergency department at UCHealth Yampa Valley Medical Center where he was seen by Dr. Laila Powers.

“I hadn’t broken a single bone in my body before this,” said Malek. “I didn’t really know how bad it was. I knew my neck was unstable, so I tried not to move a whole lot. There was definitely a lot of fear going through my head. I was lucky to have Doug with me to keep me somewhat calm.”

Spine surgery in Steamboat Springs

Following x-rays and an MRI, it was determined that Malek would need spine surgery, something he and Doug assumed would require a transfer to a larger medical center.

“Lucky for me, Dr. [Clint] Devin was there,” said Malek. “He saw me in the emergency department and scheduled surgery for me the next morning.”

“Brian sustained a break of his C4 vertebrae, also known as a tear drop fracture,” said Devin. “This type of injury can occur when someone dives into a shallow pool and strikes their head. It’s the same type of injury that occurred to Christopher Reeves, but to a lesser degree in Brian. The break caused bruising to his spinal cord, which is why Brian experienced weakness in his right arm and leg.”

Devin said the goals of surgery were to remove the bone pressing against Brian’s spinal cord and through a fusion, provide a stable environment to allow the spinal cord to recover.

Following surgery, Malek spent a day in the intensive care unit before moving to the patient care unit.

Continuum of care

“Dr. Devin checked on me in the ICU and then again the next day,” said Malek. “His bedside manner is amazing. My wife, Brandy, was still in Boulder during all this and Dr. Devin spent a solid 30 minutes on the phone with her, explaining how the surgery went and how things were looking.”

Brian Malek (far right), his brother-in-law, Doug Fashenpour, and his nephew, Zach, before flying home to Boulder.

Malek said thanks to the physical therapists who visited him, he was soon out of bed and walking. He also appreciated all the care from his nurses.

“I was still pretty grungy from mountain biking and the nurses were awesome in helping me clean up,” he said. “I even asked one of the nurses to brush my teeth and she did.”

Malek was discharged after three days in the hospital and went back home to Boulder, thanks to a special flight arranged by Doug.

“Before I left the hospital, the nurses went over my medication plan and gave me a spreadsheet so it was easy to reference what I needed to take when,” he said. “I also received thorough instructions about physical therapy exercises and even a ‘claw’ to help me pick things up and scratch my back.”

From recovery to runway

Once home, Malek continued with physical therapy and wearing a full neck brace. He couldn’t bend over and couldn’t lift more than 15 pounds. With time, he’s gained his strength back.

“I knew I had to follow everything they told me if I wanted to fly again,” he said. “Dr. Devin has an interest in flying, too, so he understands how important it is to me to get back in the cockpit.”

“Finding a shared interest or common ground with patients is always good because it helps establish trust very quickly,” said Devin. “Trust allows for meaningful discussions regarding risks, reasons for surgery, expectations and recovery. It’s important to motivate patients towards a goal that is a passion in their life. For Brian, that’s flying airplanes and getting back on his mountain bike.”

Malek returned to Steamboat Springs in late July for a follow-up visit with Dr. Devin and was cleared to return to work Aug. 1. He also plans to eventually return to mountain biking, again with safety gear and with the addition of a protective neck brace.

“I’ve been on bikes my whole life, and I’d definitely miss it if I didn’t get back on a bike,” he said. “After the accident, Brandy said she was selling my bike, but it’s still in the garage.”

“When the accident happened, I thought I could be paralyzed or at least down for a long time,” Malek continued. “It’s a miracle I’m able to be as mobile as I am and that I got to go back to flying only seven weeks after I broke my neck.”